| Advances in the use of biologic agents for the treatment of systemic vasculitis. | |
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MedLine Citation:
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PMID: 19077713 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Due to the well known toxicities of cyclophosphamide, substantial interest exists in finding other therapies to treat primary systemic vasculitis. Biologic agents have been proposed as an alternative to cyclophosphamide for these disorders because of their recent success in treating other rheumatic diseases. This article reviews the current state-of-the-art therapy with regards to the use of biologic agents as treatments for systemic vasculitis. RECENT FINDINGS: The greatest amount of experience with these agents for the treatment of systemic vasculitis is with antitumor necrosis factor agents, pooled intravenous immunoglobulin, and anti-B-cell therapies such as rituximab. Intravenous immunoglobulin is already a standard therapy for Kawasaki's disease, but should also be considered for the treatment of vasculitis associated with antineutrophil cytoplasmic antibodies when standard therapies are either ineffective or contraindicated. Early experience with tumor necrosis factor inhibitors indicates that they may be effective for the treatment of Takayasu's arteritis, but their role in the treatment of other forms of vasculitis remains controversial. Early experience with rituximab for the treatment of several forms of vasculitis has been quite promising, but must be confirmed by ongoing randomized clinical trials. SUMMARY: Biologic agents represent the next evolution in treatment for the primary systemic vasculitides. Greater understanding of these diseases has allowed us to move further away from nonspecific, highly toxic therapies toward a more directed approach. As our experience with these agents increases, they will likely form the keystone of treatment in the near future. |
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Authors:
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Sharon A Chung; Philip Seo |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Current opinion in rheumatology Volume: 21 ISSN: 1531-6963 ISO Abbreviation: Curr Opin Rheumatol Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2008-12-16 Completed Date: 2009-03-20 Revised Date: 2010-09-23 |
Medline Journal Info:
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Nlm Unique ID: 9000851 Medline TA: Curr Opin Rheumatol Country: United States |
Other Details:
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Languages: eng Pagination: 3-9 Citation Subset: IM |
Affiliation:
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Division of Rheumatology, University of California, San Francisco, California, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies, Monoclonal
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pharmacology,
therapeutic use Biological Products / pharmacology, therapeutic use* Clinical Trials as Topic / trends Humans Immunoglobulins, Intravenous / pharmacology, therapeutic use Immunologic Factors / pharmacology, therapeutic use Immunosuppression / methods, trends Immunosuppressive Agents / pharmacology, therapeutic use* Tumor Necrosis Factor-alpha / antagonists & inhibitors, physiology Vasculitis / drug therapy*, immunology, physiopathology |
| Grant Support | |
ID/Acronym/Agency:
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1K23AR052820-01/AR/NIAMS NIH HHS; K23 AR052820-05/AR/NIAMS NIH HHS; KL2 RR024130-04/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Biological Products; 0/Immunoglobulins, Intravenous; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/Tumor Necrosis Factor-alpha; 0/rituximab |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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